Documentation Effort Horizon (DEH)
How much focused work does it take to reach strong, audit-defensible documentation?
By Jeff Zila
VP AI Engineering | 1520ai
What It Is
The Documentation Effort Horizon (DEH) is a deterministic methodology that translates healthcare compliance findings into estimated remediation effort, expressed as clear, executive-legible time horizons. Instead of abstract risk scores or severity ratings, DEH answers a more operationally useful question:
How much focused work does it take to reach strong, audit-defensible documentation?
DEH is designed for regulated healthcare environments where probabilistic scoring, ambiguous findings, and score gaming create operational friction and audit exposure.
Why it Matters
Most compliance systems tell teams how worried to be. DEH tells teams how much work to allocate.
This shift:
Aligns compliance with engineering and clinical workflows
Enables realistic capacity planning (staffing, scheduling, prioritization)
Reduces debate, escalation noise, and false reassurance
Mirrors how audits actually fail: through accumulated work and structural blockers
What This Enables for Leadership
DEH gives executives an immediate, trustworthy answer to:
How big of a lift is this?
Where should we spend limited clinical and administrative time?
Which issues are quick wins vs systemic weaknesses?
Where are we exposed to audit surprises?
It reframes compliance from a reactive risk exercise into capacity management and execution planning.
How it Works
DEH evaluates documentation along two independent dimensions:
Clinical Defensibility (Narrative Strength)
Is the clinical story internally consistent, plausible, and audit-defensible?Treated as bimodal at decision time: Robust or Compromised
Regulatory Quality Gates (Administrative Hygiene)
Are required regulatory artifacts present and valid?
Pass: No issues
Soft Stops: Remediable documentation gaps
Hard Stops: Absolute regulatory blockers
Each identified issue is associated with an estimated remediation effort (minutes, hours, days, weeks+) based on real operational patterns. These effort estimates are summed to produce a cumulative remediation workload. Certain defect classes act as supremacy constraints (e.g., a single structural blocker caps the achievable state).
The Output: Documentation Effort Horizon
DEH produces a single, deterministic roll-up metric:
GREEN — Strong documentation achievable with ≤1 day of focused work
YELLOW— Strong documentation achievable with ~1 week of focused work
ORANGE — Strong documentation achievable with ~1–4 weeks of coordinated clinical & administrative work
RED— Strong documentation requires ≥1 month of sustained, multi-role effort or may not be remediable
.Key rule: Any individual Red condition prevents an overall Green classification.
These bands are order-of-magnitude planning signals, not guarantees of compliance or audit outcomes.
Documentation Effort Horizon (DEH)
IS
Deterministic
Auditor-aligned
Operationally realistic
Planning-grade
IS NOT
A Promise of Audit Success
A Legal Risk Score
A Probabilistic Prediction Engine
It estimates work required to improve documentation defensibility, enabling informed decisions.
Bottom Line
The Documentation Effort Horizon converts compliance complexity into a single, actionable signal grounded in real work. By measuring effort instead of fear, it creates clarity, discipline, and scalability in one of healthcare’s most failure-prone domains.